Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder

Bipolar Disorders Program & Molecular Psychiatry Laboratory, Hospital Clinic of Porto Alegre, Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil.
Clinical Practice and Epidemiology in Mental Health 06/2007; 3(1):5. DOI: 10.1186/1745-0179-3-5
Source: PubMed


Numerous studies have documented high rates of functional impairment among bipolar disorder (BD) patients, even during phases of remission. However, the majority of the available instruments used to assess functioning have focused on global measures of functional recovery rather than specific domains of psychosocial functioning. In this context, the Functioning Assessment Short Test (FAST) is a brief instrument designed to assess the main functioning problems experienced by psychiatric patients, particularly bipolar patients. It comprises 24 items that assess impairment or disability in six specific areas of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships and leisure time.
101 patients with DSM-IV TR bipolar disorder and 61 healthy controls were assessed in the Bipolar Disorder Program, Hospital Clinic of Barcelona. The psychometric properties of FAST (feasibility, internal consistency, concurrent validity, discriminant validity (euthymic vs acute patients), factorial analyses, and test-retest reliability) were analysed.
The internal consistency obtained was very high with a Cronbach's alpha of 0.909. A highly significant negative correlation with GAF was obtained (r = -0.903; p < 0.001) pointing to a reasonable degree of concurrent validity. Test-retest reliability analysis showed a strong correlation between the two measures carried out one week apart (ICC = 0.98; p < 0.001). The total FAST scores were lower in euthymic (18.55 +/- 13.19; F = 35.43; p < 0.001) patients, as compared with manic (40.44 +/- 9.15) and depressive patients (43.21 +/- 13.34).
The FAST showed strong psychometrics properties and was able to detect differences between euthymic and acute BD patients. In addition, it is a short (6 minutes) simple interview-administered instrument, which is easy to apply and requires only a short period of time for its application.

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    • "Measures of affective symptoms and socio-occupational function Depressive symptoms were rated with the HDRS-17 and sociooccupational function was assessed with the Functional Assessment Short Test (FAST; Rosa et al., 2007), a 24-item intervieweradministered instrument with good validity and reliability in BD (Rosa et al., 2007) and psychotic disorders (González-Ortega et al., 2010). 2.3.2. "
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    • "It was composed of six domains: (1) estimated IQ, which was evaluated with the Wechsler Adult Intelligence Scale – III (WAIS-III) vocabulary subtest (Wechsler, 1997a); (2) the processing speed index, which consists of two subtests of the WAIS-III, the digit–symbol coding and symbol search (Wechsler, 1997a); (3) executive function, which was tested by set shifting, verbal fluency, planning, and response inhibition using the Computerized Wisconsin Card Sorting Test (Heaton, 1981), the Stroop Color– Word Interference Test (Golden, 1978), the phonemic (F-A-S) and categorical (animal naming) components of the Controlled Oral Word Association Test (Benton & Hamsher, 1976), the Trail Making Test, part B (Reitan, 1958), and the Rey–Osterrieth Complex Figure (Rey, 1997); (4) visual memory and verbal learning/memory, which were assessed with the Rey– Osterrieth Complex Figure for visual memory and the California Verbal Learning Test (CVLT) (Delis et al. 1987) and the Logical Memory Scale (Wechsler Memory Scale-III; WMS-III) (Wechsler, 1997b) for learning/memory; (5) the working memory index, which was tested with three subtests of the WAIS-III (Wechsler, 1997a): arithmetic, digits forward and backward, and letter–number sequencing; and (6) attention , which was tested with the Trail Making Test, part A (Reitan, 1958), administered together with the Continuous Performance Test-II, version 5 (Conners, 2000), to measure sustained attention. Finally, psychosocial functioning was assessed by means of the FAST scale (Rosa et al. 2007). "
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